Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 23;27(4):429-450.
doi: 10.5606/tgkdc.dergisi.2019.01902. eCollection 2019 Oct.

Consensus Report on Patient Blood Management in Cardiac Surgery by Turkish Society of Cardiovascular Surgery (TSCVS), Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care (SCTAIC)

Serkan Ertugay  1 , Türkan Kudsioğlu  2 , Taner Şen  3 ; Patient Blood Management Study Group Members
Collaborators, Affiliations

Consensus Report on Patient Blood Management in Cardiac Surgery by Turkish Society of Cardiovascular Surgery (TSCVS), Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care (SCTAIC)

Serkan Ertugay et al. Turk Gogus Kalp Damar Cerrahisi Derg. .

Abstract

Anemia, transfusion and bleeding independently increase the risk of complications and mortality in cardiac surgery. The main goals of patient blood management are to treat anemia, prevent bleeding, and optimize the use of blood products during the perioperative period. The benefit of this program has been confirmed in many studies and its utilization is strongly recommended by professional organizations. This consensus report has been prepared by the authors who are the task members appointed by the Turkish Society of Cardiovascular Surgery, Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care to raise the awareness of patient blood management. This report aims to summarize recommendations for all perioperative blood- conserving strategies in cardiac surgery.

Keywords: Cardiac surgery; bleeding.; patient blood management; transfusion.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1
Figure 1. Preoperative management of dual antiplatelet therapy according to thrombotic and bleeding risk in cardiac surgery. ASA: Acetylsalicylic acid.
Figure 2
Figure 2. Perioperative management of dual antiplatelet therapy in cardiac surgery. * After discontinuation of P2Y12 within 72 hours without bolus dose; Tirofiban: 0.1 µg/kg/min (If creatinine clearance <50 mL/min 0.05 ?g/kg/min); Eptifibatide: 2.0 µg/kg/min (If creatinine clearance <50 mL/min 1.0 ?g/kg/min); + After discontinuation of P2Y12 within 72 hours without bolus dose; 0.75 µg/kg/min (No need to dose adjustment in renal failure minimum 48 hours to maximum 7 days) ** If no oral intake ++ If no oral intake *** Within 24-48 hours when oral intake starts, clopidogrel should be given in 75 mg/day maintenance dose following 300-600 mg bolus dose. Prasugrel and ticagrelor are not recommended.
Figure 3
Figure 3. Perioperative management of oral anticoagulant therapy in cardiac surgery. Bridging algorithm for the patients using oral anticoagulation and undergoing cardiac surgery. VKA: Vitamin K antagonist; INR: International normalized ratio; UFH: Unfractionated heparin; LMWH: Low molecular weight heparin; DOAC: Direct oral anticoagulant; CrCI: Creatinine clearance.
See this image and copyright information in PMC

References

    1. Ranucci M, Baryshnikova E, Castelvecchio S, Pelissero G, Surgical and Clinical Outcome Research (SCORE) Group Major bleeding, transfusions, and anemia: the deadly triad of cardiac surgery. Ann Thorac Surg. 2013;96:478–485. - PubMed
    1. Pagano D, Milojevic M, Meesters MI, Benedetto U, Bolliger D, von Heymann C, et al. 2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery. Eur J Cardiothorac Surg. 2018;53:79–111. - PubMed
    1. Kudsioğlu T, Ertugay S, editors. Hasta Kan Yönetiminde Ortak Görüş. Ankara: Sözkesen Matbaacılık; 2019.
    1. Sahu S, Hemlata1 , Verma A. Adverse events related to blood transfusion. Indian J Anaesth. 2014;58:543–551. - PMC - PubMed
    1. Wilkerson DK, Rosen AL, Gould SA, Sehgal LR, Sehgal HL, Moss GS. Oxygen extraction ratio: a valid indicator of myocardial metabolism in anemia. J Surg Res. 1987;42:629–634. - PubMed

LinkOut - more resources